SouthEast Asian Research Collaboration in Hepatitis (SEARCH) (360G-Wellcome-206296_Z_17_Z)

New direct acting antivirals (DAAs) to treat hepatitis C (HCV) have the potential to overcome many current barriers to curative treatment throughout the world. However, licensed durations of therapy will overtreat many individuals with unnecessary costs and inconvenience to patients who often have to pay for (at least part) of their treatment. The central work within this collaborative will be a large randomised trial with an innovative design to evaluate different treatment strategies suitable for scale up in low income countries. Two different treatments will be evaluated, strategies being dropped early if not demonstrating high enough cure rates. The trial will be based in Vietnam, home to an estimated 1 million HCV-infected individuals with a high proportion of genotype 6 HCV infections (relatively neglected by clinical studies to date). As a low/middle-income country, Vietnam can access more affordable generic therapies allowing studies to be done that would be prohibitively expensive in wealthier countries. The collaborative encompasses wider expertise to inform the use and scale up of DAAs (i) Whole genome sequencing to understand the impact of viral resistance mutations, particularly in G6 (ii) Pharmacokinetic/pharmacodynamics modeling (iii) Health economic analysis to evaluate cost/benefits of different treatments and treatment strategies